How has COVID-19 affected the mental health of prison staff in England?

In a recent study posted to the medRxiv* preprint server, researchers at the University of Southampton, University of Manchester, and the UK Health Security Agency analyzed the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on the mental well-being of prison staff in England.

​​​​​​​Study: The mental wellbeing of prison staff in England during the COVID-19 pandemic: a cross-sectional study​​​​​​​. Image Credit: MIA Studio / Shutterstock

Background

The prison system in England and Wales comprises 117 prisons, housing about 80,000 inmates and 53,000 staff members. During the initial phase of the SARS-CoV-2 pandemic, prisons were characterized as high-risk sites for outbreaks due to overcrowding and a substantial likelihood of severe coronavirus disease 2019 (COVID-19) in inmates and employees. In jails throughout England, SARS-CoV-2-associated infection control strategies implemented in March 2020 restricted the access of the residents to social events and visits, in-person education, work prospects, and training programs.

Correctional facilities employ a wide range of professionals, such as probation officials, prison officers, nurses, administrators, doctors, chaplains, psychologists, and managers. Despite some speculation that the pandemic and changes in prison regimes have negatively impacted the well-being of prison staff in England, there is little evidence to support this.

About the study

The cross-sectional study aimed to investigate the mental well-being of prison staff in England during the pandemic and determine the associated factors linked to well-being through online surveys and self-completed hardcopy. The research sites were 26 jails in England, selected to represent the broader closed prison estate in England. The study was open to all employees working in the 26 jails between July 20, 2020, and October 2, 2020. 

The Short-version of the Warwick-Edinburgh Well-Being Scale (SWEMWBS) was used to measure the primary outcome of the study, i.e., well-being. Indirectly standardized information from the Health Survey for England between 2010 and 2013 and a one-sample t-test was used to compare staff well-being to that of the England population.

Relationships with measures of mental well-being were investigated using multivariate linear regression modeling, controlling for sex, age category, smoking status, ethnicity, presence of comorbidities, Her Majesty's Prison and Probation Service (HMPPS) region, and occupation.

Results

Overall, the study results demonstrated that 2,534 subjects were involved in the research, translating to a response rate of 22.2%. The study volunteers were, on average, 44 years old, 53% were women, and 93% belonged to the White ethnicity.

The mean SWEMWBS score of the sample was 23.84, whereas the normalized population mean score was 23.57. Indeed, the variation in means was statically relevant yet not at a clinically significant level, based on the cutoff of one point on the SWEMWBS scale. The results illustrated that prison employees in England during the SARS-CoV-2 pandemic had similar well-being status to the general English community before the pandemic.

Male sex, older age, Black British/Black ethnicity, working in the health staff team, employment in specific prison regions (e.g., R5 HMPPS region), and non-smokers were all substantially associated with higher well-being. However, the researchers also noted that the total predictive value of the model was low.

In contrast to earlier cross-sectional studies conducted before the pandemic, just 4.4% of staff ratings indicated potential mental illness in the current research. It was unclear why the results of the present study differ from those of studies conducted before the COVID-19 pandemic; possible explanations include discrepancies in study design or actual differences in the well-being of prison staff.

Conclusions

The authors claimed that with 2,534 participants, their study was the most extensive study to date to explore the mental well-being of prison staff in the UK and the first peer-reviewed study examining this during the COVID-19 pandemic.

The study findings surprisingly implied that the mental well-being of prison employees was similar to the general England population before the COVID-19 pandemic as assessed by SWEMWBS. The decrease in prison violence since the commencement of the SARS-CoV-2 pandemic may be one cause, while the exact cause was unknown.

The team stated that past studies that have examined prison employee well-being and recruited via trade union routes were less likely to be representative of the jail employee population than the sampling frame utilized presently, i.e., all personnel at 26 England jails. Well-being was assessed using SWEMWBS, validated across the UK population. The low response rate, i.e., 22.2%, and the fact that several of the variables in the regression model were self-documented raise the possibility of some bias.

Besides, the authors mentioned that qualitative research conducted in different prison settings might contribute to a better comprehension of employee well-being in the context of the COVID-19 pandemic and the pandemic's effects on jails. Interventions to enhance the well-being of prison workers also require more research. Research in these areas in partnership with important organizations like the Prison Officers Associations and HMPPS would assist develop more effective techniques for boosting employee well-being and fostering a collaborative learning culture.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Shanet Susan Alex

Shanet Susan Alex, a medical writer, based in Kerala, India, is a Doctor of Pharmacy graduate from Kerala University of Health Sciences. Her academic background is in clinical pharmacy and research, and she is passionate about medical writing. Shanet has published papers in the International Journal of Medical Science and Current Research (IJMSCR), the International Journal of Pharmacy (IJP), and the International Journal of Medical Science and Applied Research (IJMSAR). Apart from work, she enjoys listening to music and watching movies.